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Biomedical subjects

J E Bock

Publications and source records attributed to J E Bock.

At least 55 records · Page 3Linked to original sources
PubMed1991

[The relationship between low pH in the umbilical cord artery in neonates and later development of cerebral paresis].

Routine determination of the pH in umbilical arterial blood immediately after delivery is a commonly employed variable for assessing the risk of subsequent cerebral paresis caused by hypoxia. Opinions differ regarding the lower limit for normal NS-pH (acidosis limit) and this is due mainly to variable conceptions of what a normal delivery is. Lower limits from 7.04 to 7.14 are thus observed if the limit -2 SD is chosen. Even if the limit of 7.04 is chosen, only very few of the infants who are acidotic on delivery subsequently develop cerebral paresis. The most important reason for this is that the prevalence of cerebral paresis developed as a result of hypoxia during delivery is very low and that a low NS-pH value most probably originates from a neonate who recovers without cerebral paresis. Another reason is that the relationship between the pH value and the degree of hypoxia is far from perfect and this holds also true for the relationship between the degree of hypoxia and cerebral paresis. It is therefore concluded that in connection with cerebral paresis, NS-pH does not fulfill the requirements of a diagnostic test. Determination of NS-pH may, on the other hand, be of significance for neonatal treatment as the combination of a low Apgar score and NS-pH is a reasonable predictor for the neonatal morbidity.

Cerebral Palsy↗
PubMed1991

HPV 11, 16 and 18 DNA sequences in cervical swabs from women with cervical dysplasia: prevalence and associated risk of progression.

Cervical swabs obtained from 164 women with histologically proven preinvasive and invasive cervical neoplasia were analysed for HPV type 11, 16 and 18 DNA by filter in situ hybridisation. HPV 16 or 18 was detected in 8 of 24 swabs from patients with invasive squamous cell carcinoma (33%), in 59 of 100 patients with carcinoma in situ or severe dysplasia (59%) and in 16 of 40 patients with mild or moderate dysplasia (40%). HPV 6 or 11 was found in only 2% of all swabs. Thirty-eight of the patients participated in a prospective follow-up study and were monitored non-invasively by cytology and colposcopy for 8 to 36 months. 25 patients had persisting or progressive lesions, 13 of which harboured HPV 16 or 18. Of 13 patients who had complete resolution of the dysplasia, only 2 were HPV-positive. The study indicates a significantly higher risk of malignant progression when the cervical dysplasia is associated with HPV 16 or 18 infection.

Adolescent↗
PubMed1991

[Pregnancy and labor in women with spinal cord injuries].

Case histories of three pregnant women with spinal cord lesions are presented. These otherwise healthy women are at increased risk for silent preterm labour and complicated urinary tract infections. Autonomous hyperreflexia may be severe and even life threatening. Prevention and treatment of autonomic hyperreflexia in these women require supervision and coordinated care by obstetricians and physicians with special interest in spinal cord lesions.

Adult↗
PubMed1991

Case-control study of risk factors for cervical neoplasia in Denmark. I: Role of the "male factor" in women with one lifetime sexual partner.

Possible risk factors for cervical cancer were investigated in 645 women, 20-49 years of age from Copenhagen, with histologically confirmed cervical cancer or carcinoma in situ and in 614 controls drawn at random from the female population of the same area. To study the role of the "male factor", monogamous cases and controls together with their husbands were invited for further examination. This included a personal interview, a blood sample for analysis of herpes simplex virus antibodies, and a penile swab for papillomavirus analysis. In total, 41 case couples and 90 control couples were enrolled (89% and 92% of eligibles, respectively). The most significant risk determinants were a history of genital warts in the male (RR = 17.9 for ever vs. never) and ever having used condoms (RR = 0.2). Other potentially important factors, although not statistically significant, were ever having visited prostitutes (RR = 2.6, p = 0.14), circumcision (RR = 0.3, p = 0.18), and a history of genital warts in the female (RR = 4.6), p = 0.09). Having a husband with a history of multiple sexual partners was also associated with an increased crude risk, but when adjustment was made for husband ever having had genital warts, use of condom, and age, no significant excess risk was observed. Human papillomavirus DNA, which was tested for with ViraPap and ViraType, was detected in one of the controls, and in only 2 case husbands. This study points to the importance of "high-risk males" for the development of cervical cancer in their sexual partner; the results support the infectious nature of the disease.

Adult↗
PubMed1991

Human papillomavirus type 16 in vulvar carcinoma, vulvar intraepithelial neoplasia, and associated cervical neoplasia.

Vulvar intraepithelial neoplasia (VIN) is becoming more widespread and the patients are becoming still younger. Although progression to invasive vulvar carcinoma is uncommon, local recurrences are frequent and about one-quarter of the patients have multicentric genital disease. The aim of the present study was to search for a possible significant association of human papillomavirus (HPV) infection with vulvar carcinoma, recurrences, and multicentric disease. We used the polymerase chain reaction to examine vulvar and cervical biopsies from 43 patients with vulvar neoplasia for HPV type 16, which is the subtype most often detected in genital malignant or premalignant lesions. HPV 16 DNA sequences were found in 14 of 24 (58%) vulvar squamous carcinomas and in 15 of 19 (79%) VIN lesions. Nine patients (21%) had associated cervical neoplasia and six of these harbored HPV 16 in both lesions. Patients with recurrent intraepithelial neoplasia had a significantly higher incidence of HPV 16-positive lesions. No association was found with regard to the occurrence of multicentric disease or risk of malignant progression.

Adult↗
PubMed1991

Laser and cryo surgery for cervical intraepithelial neoplasia. A randomized trial with longterm follow-up.

In a randomized study, 204 patients with exocervical intra-epithelial neoplasia were allocated to either laser evaporation (103) or cryocoagulation (101). The patients were treated on an outpatient basis without anesthesia. In the case of initial treatment failure the same method was to be used for retreatment. One hundred and eighty-seven patients were followed-up for an average of 50 months (12-80). Eighty-six of 94 laser-evaporated patients (91%) and 89 of 93 cryocoagulated patients (96%) were cured after one treatment. Five of 8 laser failures and 3 of 4 cryo failures were cured by retreatment. The cure rate after one or two laser evaporations was 97% (91 of 94 patients), and after one or two cryo coagulations, 99% (92 of 93 patients). Eighty per cent of residual or recurrent neoplasia occurred within 15 months and 96% within 2 years of treatment. No invasive neoplasia occurred during the follow-up period and no tendency was seen towards higher grades of intra-epithelial neoplasia in the failures compared with the initial diagnoses. It is concluded that laser evaporation and cryocoagulation are equally effective for the treatment of exocervical intra-epithelial neoplasia.

Cryosurgery↗
PubMed1990

[Sexual habits of women aged 20-39 years. A comparison of 3 population-based studies from Nyköbing Falster, Copenhagen and Nuuk/Godthåb].

The sexual habits in women aged 20-39 years chosen at random were investigated. A total of 513 women from Copenhagen participated while there were 586 women from Nykøbing Falster and 661 women from Nuuk (Godthåb) in Greenland. The women from Copenhagen replied to a questionnaire investigation while women from the other two regions were interviewed personally. The age of commencement of sexual activity was considerably lower in Godthåb in women of all age groups than in Copenhagen and Nykøbing Falster e.g. the prevalence of women with age on commencement of sexual activity less than or equal to 16 years was 70-80% in Godthåb while the corresponding figures for Copenhagen were 50-60% and for Nykøbing Falster 30-58%. Comparison with previous investigations revealed that the average age at the first coitus showed a tendency to decrease in all three regions during the past 20-30 years. The difference in the age at the first coitus between a provincial town (Nykøbing Falster) and a city (Copenhagen) was present only in the case of women in the oldest age group (35-39 years) and a geographical levelling appears to have occurred in the younger age groups (20-24 years) concerning the age at commencement of sexual activity. Women in Greenland had significantly more partners than women in the two South Danish regions. In Godthåb, the prevalence of women with greater than or equal to 40 partners was thus 22.4% while the prevalences in Copenhagen and Nykøbing Falster were 3.5% and 0.3%, respectively. The prevalences of women with 0-1 partners were 1.7%, 10.7% and 20.4%, respectively in Godthåb, Copenhagen and Nykøbing Falster.

Adult↗
PubMed1990

[The significance of the environment for delivery at a special department].

A material of 292 normal pregnant women was subdivided at random for delivery either in the traditional delivery room or a newly established environmental room. The alterations in the physical environment of delivery did not result in more numerous spontaneous deliveries. A high frequency of episiotomies, stimulation of contractions and artificial deliveries in primiparae occurred particularly when it is considered that two thoroughly investigated groups of low-risk pregnant women were concerned. However, qualitative differences in the experience of the course of delivery were found in favour of the environmental room. The quality of the experience of delivery did not depend so much on the physical environment but more on contact with the staff members responsible for conduct of the delivery.

Delivery, Obstetric↗
PubMed1990

Value of four models for selecting patients for local excision of invasive squamous cell carcinoma of the vulva.

For 75 women with squamous cell carcinoma of the vulva who underwent radical vulvectomy and inguinofemoral lymphadenectomy, the authors assessed the efficacy of four models for selecting patients who could have been treated adequately with local excision of the tumor. Each of the three models proposed by Andreasson and Nyboe covered 25% of the patients, none of whom had groin metastases or died of cancer. Local recurrence in the vulva occurred in 10%. A model suggested by the International Society for the Study of Vulvar Disease covered almost 10% of the patients. One of seven patients had groin metastases, none died of cancer, and one of seven developed local recurrence in the vulva. The criteria of the clinically best suited model are tumor not situated on the clitoris and less than 4 cm in diameter, with only slight hyperchromasia. This model ought to be tested in a randomized study.

Adult↗
PubMed1988

Trainability of the pelvic floor. A prospective study during pregnancy and after delivery.

The contractibility and trainability of the pelvic floor were investigated during pregnancy and after vaginal delivery in 86 healthy primiparae. One group (TG) (n = 38) was instructed in training the pelvic floor from the 33rd week of pregnancy, whereas the other group (non-TG) (n = 39) was not. Both groups were measured by perineometry five times between 33rd-39th week of pregnancy and approximately 8 weeks after delivery. Half of the women were also measured 8 months post partum. At the beginning of the study both groups showed the same strength of the pelvic floor. 8 weeks and 8 months after delivery the TG were significantly (p less than 0.05) better able to contract the pelvic floor compared with the non-TG. 8 months post partum, the TG had regained the initial values of pelvic floor contraction as from 33rd week of pregnancy, whereas the non-TG had not. During pregnancy there was a better ability to contract the pelvic floor in the TG vis-à-vis the non-TG, though not significantly so. No difference in the course of delivery was observed, and the frequency of complications was the same in the two groups.

Adolescent↗
PubMed1987

Intrathecal administration of morphine for the relief of pains in labour and estimation of maternal and fetal plasma concentration of morphine.

Thirteen healthy women in active labour received an intrathecal injection of morphine 1.0 mg. Eighty-five percent (11 patients) experienced acceptable or good pain relief. Analgesia set in 15-45 min after injection and reached a maximum after 15-120 min and lasted until delivery. Eighty-five percent (11 patients) of the patients developed mild side-effects i.e., pruritus, nausea and emesis. The intrathecal injection of morphine did not adversely affect the condition of the infant. Venous blood samples from the patients and umbilical cords for estimation of plasma morphine showed extremely low concentrations. No patients experienced any discomfort during the injection of morphine. These results indicate that morphine 1.0 mg administered intrathecally decreases labour pains to an acceptable level.

Anesthesia, Obstetrical↗
PubMed1987

Outpatient treatment of cervical intra-epithelial neoplasia. The CO2 laser versus cryotherapy, a randomized trial.

In a randomized study, 204 patients were allocated to either laser or cryo treatment for cervical intra-epithelial neoplasia (CIN). The patients were treated on an outpatient basis without anesthesia unless other conditions requiring anesthesia had to be dealt with at the same time. Both the laser and the cryo method were highly acceptable to the patients. Slightly more patients experienced moderate or severe pain during laser treatment, compared with cryo treatment (P = 0.05). Peroperative hemorrhage did not exceed 25 cc except for one laser-treated patient. Postoperative vaginal discharge was more often seen after cryo coagulation, the discharge being malodorous in 36% of cryo-treated patients and in 17% of laser-treated patients. Pelvic inflammatory disease was found in one patient in each treatment group. Postoperative spotting occurred more often in laser-treated patients (49%) than in cryo-treated patients (22%). At follow-up colposcopy 3 months after treatment, the squamocolumnar junction was fully visible significantly more often in laser-treated patients (P less than 0.001). The cure rates after one laser or cryo treatment were 90% and 91%, respectively. Subsequent to 19 initial treatment failures, 8 patients have at present been retreated with the same method as initially used, and all 8 are cured. The cure rates after one or two treatments are 96% in the laser group and 93% in the cryo group. The rates are preliminary, due to the short observation time. Publications will appear when all patients have been followed for 2 and 5 years.

Adult↗